Real-life use of thromboprophylaxis in patients hospitalized for pulmonary disorders: A single-center retrospective study
Real-life use of thromboprophylaxis in patients hospitalized for pulmonary disorders: A single-center retrospective study
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DOI：
10.17219/acem/68474
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发表时间：
2018-02-01
影响因子：
2.1
通讯作者：
Undas, Anetta
中科院分区：
文献类型：
--
作者：
Lukaszuk, Robert F.;Plens, Krzysztof;Undas, Anetta
背景资料。在住院的内科患者中，血栓预防措施的使用不足在世界范围内仍然很常见。对于肺部疾病患者的血栓预防在医院的日常实践中的应用，我们知之甚少。本研究的目的是评估药物预防静脉血栓栓塞症(VTE)在现实生活中肺部疾病患者中的应用。材料和方法。在这项回顾性研究中，使用Padua预测评分和Caprini VTE风险评估两种有效的评分系统，对2014年1月至12月在同一三级肺医学中心因肺部疾病住院(中位数6天)的2011例患者(男性1133例，女性878例)进行了VTE风险评估。使用PADUA预测评分，我们确定了428名(21.28%)静脉血栓栓塞症高危患者，其中167名(39.01%)接受了低分子肝素血栓预防，261名(60.98%)高危人群没有接受血栓预防(P<；0.001)。共有888名(44.16%)在Caprini VTE风险评估中得分在5分或以上的患者被确定为VTE的高风险受试者，其中34.79%的患者接受血栓预防。在静脉血栓形成的高危患者中，579人(65.20%)没有接受适当的血栓预防(p<；0.001)。在因肺癌或肺炎住院的患者中，血栓预防措施的使用不足更为常见(分别为50.60%和24.87%的未采取预防措施的VTE高危患者)。无论使用何种评分系统，在住院的肺部疾病患者中，血栓预防都没有得到充分利用。在这一组患者中，血栓预防措施的实施应得到显著改善。
Background. Underuse of thromboprophylaxis in hospitalized medical patients is still common worldwide. Little is known about the use of thromboprophylaxis in patients with pulmonary diseases in everyday hospital practice.Objectives. The aim of this study was to assess the use of pharmacological prophylaxis of venous thromboembolism (VTE) in real-life patients with pulmonary diseases.Material and methods. In this retrospective study, 2 validated scoring systems, i.e., the Padua prediction score and Caprini VTE risk assessment, were used to assess the VTE risk in 2011 patients (1133 men and 878 women), aged 18 years or more, hospitalized for pulmonary diseases (median 6 days) in a single tertiary pulmonary medical center from January to December 2014.Results. Using the Padua prediction score, we identified 428 (21.28%) patients at a high risk for VTE, including 167 (39.01%) who received thromboprophylaxis with low-molecular-weight heparin, and 261 (60.98%) individuals at a high risk without thromboprophylaxis (p < 0.001). A total of 888 (44.16%) patients who scored 5 points or more using the Caprini VTE risk assessment were identified as subjects at a high risk for VTE, including 34.79% of patients receiving thromboprophylaxis. From among patients at a high risk for VTE, 579 (65.20%) did not receive appropriate thromboprophylaxis (p < 0.001). Underuse of thromboprophylaxis was observed more commonly among patients hospitalized for lung cancer or pneumonia (50.60% and 24.87% of patients at a high risk for VTE without prophylaxis, respectively).Conclusions. Thromboprophylaxis is underutilized in hospitalized patients with pulmonary diseases regardless of the scoring system used. Implementation of thromboprophylaxis should be markedly improved in this patient group.